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A study of IVIM magnetic resonance imaging to identify wrist synovitis in rheumatoid arthritis
LI Shenghu  JIANG Zhaoguan 

Cite this article as: Li SH, Jiang ZG. A study of IVIM magnetic resonance imaging to identify wrist synovitis in rheumatoid arthritis[J]. Chin J Magn Reson Imaging, 2022, 13(4): 132-136. DOI:10.12015/issn.1674-8034.2022.04.026.

[Abstract] Objective To assess the feasibility of intravoxel incoherent motion (IVIM) magnetic resonance imaging for the detection of synovial thickening of the wrist in patients with rheumatoid arthritis.Materials and Methods Thirteen patients (mean age 47 years, range 26 to 74 years) with a definite diagnosis of active rheumatoid arthritis were recruited. All patients underwent 3.0 T MRI including proton density weighted-spectral attenuated inversion recovery (PDW-SPAIR), dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and IVIM. Scanning range includes the distal ulnar radius, wrist joint and 1-5 metacarpophalangeal joints. Region of interests were manually drawn on high signal regions in coronal PDW-SPAIR, and copied to the same position of diffusion weighted imaging (DWI) and enhancement images by three different radiologists. ADC values, permeability parameters (Ktrans, Kep, Ve, Vp) and IVIM parameters (f, D*, D) were automatically acquired and recorded. Interobserver agreement was assessed using Fleiss Kappa analysis. The relationship between MRI enhancement results and ADC values, quantitative permeability parameters, quantitative IVIM data were evaluated using Spearman correlation coefficient. The ability of each permeability parameter to identify synovial thickening was evaluated using the area under the ROC curve (AUC). The AUCs were furtherly compared by Delong test. P<0.05 was considered a statistically significant difference.Results There was good agreement of inter-reader evaluation (Fleiss Kappa value=0.718, 95% CI: 0.717-0.720, P<0.05). The degree of enhancement was positively correlated with Ktrans (r=0.933, P<0.05). There was no significant difference in the values of Kep、Ve、Vp、f and D* values in identifying synovial thickening (P>0.05). The Ktrans correlated with ADC values and D values [r=-0.395 (95% CI: -0.532--0.212), r=-0.489 (95% CI: -0.609--0.342), respectively, P<0.05]. The AUC value of D* (0.793, 95% CI: 0.712-0.873) was significantly higher than that of ADC (0.706, 95% CI: 0.602-0.810, P<0.05).Conclusions IVIM MRI can be used to detect rheumatoid wrist synovitis.
[Keywords] rheumatoid arthritis;synovitis;intravoxel incoherent motion;magnetic resonance imaging;wrist joint

LI Shenghu   JIANG Zhaoguan*  

Department of Radiology, Wuxi Hospital of Traditional Chinese Medicine, Wuxi 214071, China

Jiang ZG, E-mail:

Conflicts of interest   None.

Received  2022-01-02
Accepted  2022-03-25
DOI: 10.12015/issn.1674-8034.2022.04.026
Cite this article as: Li SH, Jiang ZG. A study of IVIM magnetic resonance imaging to identify wrist synovitis in rheumatoid arthritis[J]. Chin J Magn Reson Imaging, 2022, 13(4): 132-136.DOI:10.12015/issn.1674-8034.2022.04.026

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